MOLECULAR DIAGNOSIS IN BACTEREMIA ASSOCIATED TO TOOTH BRUSHING AND CHEWING IN PATIENTS WITH PERIODONTITIS

Objectives: To evaluate the frequency of bacteremia induced by tooth brushing and chewing evaluated by nested polymerase chain reaction (N-PCR), and hemoculture in patients with periodontal disease. These results were confirmed by sequencing.
Methods: Forty two patients with chronic and aggressive periodontitis participate in a quasi-experimental clinical study. Under aseptic environment a catheter was introduced into the antecubital vein for sequential blood sampling. Six samples of 15 ml were taken; before the first time (T0) to assess the presence or absence of microorganisms in blood; other samples were taken after tooth brushing (T1) and 15 minutes after (T2). An hour later a new take was performed to confirm the absence of bacteria to start chewing cycle (T3). After chewing (T4) and 15 minutes after (T5) were taken other samples. The frequencies of detection of microorganisms in blood at different times by the two techniques and the frequency of bacteremia after brushing and chewing were established. Comparative analyzes between periodontal diagnosis techniques and were performed with chi2 test (p <0.05). Seventeen samples were evaluated by sequencing and a comparison of the N-PCR, sequencing and hemoculture blood was performed to establish P. gingivalis in blood.
Results: 52.3% of patients were positive for the presence of microorganisms in blood at any time evaluated. Bacteremia for tooth brushing was 33.9% and 12.5% for chewing; 21.4% of patients had bacteria or DNA in blood before inducing bacteremia. Bacteriemia was more prevalent in aggressive periodontitis (p<0.05). P. gingivalis was the most common organism found in peripheral blood and N-PCR technique showed greater sensitivity than hemoculture for detection. Sequencing confirmed the results of N-PCR.
Conclusions: The presence of microorganisms in peripheral blood is frequent in patients with periodontitis. Bacteremia is induced by Tooth brushing and chewing. P. gingivalis is the most common microorganism during bacteremia and molecular techniques improve the sensitivity for its detection.